HomeMy WebLinkAbout03-28-06
PETITION FOR PROBATE and GRANT OF LETTERS
Estate of Benny E. Tays
Also known as
No. 2-00<0 - 02 7'+
To: Register of Wills for the County of
Cumberland County in the
Commonwealth of Pennsylvania
, deceased
Social Security No. 425-58-0983
The petition of the undersigned respectfully represents that:
Your petitioner, who is 18 years of age or older an the executor named in the last Will of the above
decedent, dated July 16, 2004 and codicil(s) dated nla
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his last family or
principal residence at Manor Care, 940 Walnut Bottom Road, Carlisle, P A 17013.
Decedent, then 71 years of age, died March 15, 2006, at Manor Care.
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the Will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decedent at death owned property with estimated values as follows:
(If domiciled in P A) All personal property
(If not domiciled in P A) Personal property in Pennsylvania
(If not domiciled in P A) Personal property in County
Value of real estate in Pennsylvania
Situate as follows:
~~ ~t'Il~ ~LJ
$
$
$
$
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented
herewith and ~~rant of letters testamentary thereon.
-. .... . {/c:-
C-c:t~ .(~~:?,.. I C cvJi!-.
Edward Ege ;/
14 Kutz Road. Carlisle. P A 17013
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF CUMBERLAND
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and
correct to the best of the knowledge and belief of petitioner(s) and that as personal representative(s) of the
above decedent petitioner(s) will well and truly administer the estate according to law.
&~L('rJQ
Edward Ege
Sworn to or affirmed and subscribed
Before me this2&dh day of March
2006.
.~ '-1tV1MAA~~
Pf);-tJt(t1J4-IuJJ, d1fudtI Register -
No. 200~-D27+
Estate of Benny E. Tays, Deceased
DEGREE OF PROBATE AND GRANT OF LETTERS
AND NOW, fY1.McAt :zgin ,2006, in consideration of the petition on the reverse side
hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated July 16, 2004 described therein be admitted to probate and filed
of record as the last will of Benny E. Tays and Letters Testamentary are hereby granted to Edward Ege.
FEES
Probate, Letters, Etc.............$ {PO.OCl
Short Certificates (3)............ $ I:J-. 00
R0~hJbiation.....................$ IS DO
fef If au;o $ 16 00
TOTAL $ loJ.. 00
Filed.~~cA.!?-f. ~.~ .. .;?;9.Q~.. .. . ...... .. .
,
nald E. Johnson squire
8 West Pomfret treet
Carlisle, P A 17013
717-243-0123
Thi ~ IS to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
LOCJI Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy, by photostat or photograph.
No.
~ ~. ~eu..&.~~ . ,
Local Registrar ~
Fee for this certificate. $6.00
p
12270346
MAR 2 0 2006
Date
C)"'t
Hl05.143 Rev. 01106
TVPElPRIHT IN
PERMANENT
BLACK INK
1 Name of Decedent (First, middle, last)
Benny E. Tays
5. fvJe (Last birthday)
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH STATE FILE NUMBER
A .\
3. Social Security Nuntler 4. Dale of Dealh (Month, day, year)
Yrs.
425 - 58 -0983
March 15, 2006
71
7. Dale 01 Birth Month, da , ear
22, 1934
Other:
o ERIOu alieni 0 DOA III Nursin Home 0 Residence 0 Other. S I:
9 Was Decedent of Hispanic Origin? 10. Race: American Indian, Black. WMe. ele.
Ck No 0 Yes (If yes. specify Cuban, (Spedfj1
Mexican, Puerto Rican, etc.)
White
!!b County 01 Death
Cumberland
S.Middleton Twp. Manor Care Health Services
13. Decedent's Education S eci
E1ementarylSecondary (0-12)
hi hest rade co leted
College (1-4 or 5+)
14. Marital Status: Married, Never married. 15. Surviving'Spouse (II wife. give maiden name)
N~~~tpivo~t~
17a. Stale
PA
Cumberland
Did Decedent
Live in a 17c.!X Yes, Decedent Lived in
Township?
!=;nllrh Mi nrll prnnrwp.
In. County
17d. 0 No, Decedent Lived w~hin
Actua! Limits of
City.1loro
19. Mother's Name (First. middle. maiden surneme)
Herbert E. Tays, Sr.
Miriam Fughat
2Ob. Informanl's Mailing Address (Slreet. c~yilown, stale, zip code)
14 Kutz Rd., Carlisle, Pa 17013
2Oa. Infolmant's Name (Type/print)
Ed Ege
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en
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en
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21C. Place of Disposition (Name of cemelery ~crematory or olher place)
21d. Location (Cityilown, state, zip code)
22c. Name and Mdress of Facility
219 N. Hanover
" q
CAUSE OF DEATH (See Instructions and examples)
hem 27. Part I: Enlel Ihe ~ - diseases, injuries. or colT1lrlCations -that d~eclly caused the dealh. DO NOT entel terminal events such as cardiac arrest,
respiratory arrest, or ventricular fibriHalion without showilg the etiology. DO NOT abbreviale. Enler only one cause on a line.
IMMEDIATE CAUSE (Final disaase or r!:-..,~. -) J.... V ~ t ~. :f \' ~\. ("" V e....
cond~lOI11esuh",glndealh) -? a. .. 'l( "ii' ~V-- ~ ~_
Due to (or as a co~uence on:
: Approximate interval:
: onset to death
{2.(~ 2s55 1 (,. L
26. ,!,ss}<<se Referred to a Medical ExaminerlCoroner?
CfV'VBS 0 No
Part 1/: Enter othar sianificanl cond~ions contributino 10 dealh. 28. Did Tobacco Use Contrilute 10 Death?
but nol resuhing in the underlying cause gillen in Part I. 0 Ves 0 Probably
~ 0 Unknown
29. If Female:
o Not pregnant within pasl year
o Pregnanl al time 01 death
o Not pregnant. but pregnant within 42 days
of dealh
o Not pregnant, but pregnant 43 days to 1 year
belore death
o Unknown if pregnant within the past year
32c. Place of Injury: Home, Farm, Street. Factory. Office
Building. ele. (Specify)
· lIems 24.26 roost be colT1lleted by person
who pronounces death.
24. lImB otDeath
Sequentially IIs1 condilions. ~ any.
leading to the cause listed on Line a
- Enler the UNDERL VING CAUSE
. (disease or injury that in~iated the
evenls resuhing in death) LAST.
Due 10 (or as a consequence on:
,---
,--
Due 10 (or as a consequence on:
M.
32f If Transportation Injury (SpeciM
o DriverlOperator 0 Passengef
o Pedeslrian 0 Other.. Specify:
tun!' nil..,. e r Certifier
. ! . ~~. p-O'
001011S-- L
32g. Location (Slreel. cityilown. stale)
3Oa. Was an Autopsy
Performed?
o Yes ~o
JOb. Were Autopsy Findings
Available Prior to ColT1llelion
of Cause of Death?
o Ves 0 No
31. M,nerofDeath
., Natural 0 Homicide
o Accident 0 Pending Investigalion
o Suicide 0 Could Nol Be Determined
320. Date 01 Injury (Month, day, year)
32b. Describe how In;ury Occurred:
32d. Time of Injury
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o
W
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33a. Certtller (check only one)
. Certifying physician (Physician certifying cause of dealh when anolher physician has pronounced death ana completed Item 23)
To the best of my knowledge, death occurred due to the cause(s) and manner as stated ...................................................................................................................
. Pronouncing and certifying physician (Physician both pronouncing death end certifying 10 cause of death)
To the best of my knowledge. death OCCU"ed at the time. dale, and place, and due to the cause(s) and manner as stated.......................................................................O
Medical examlnerlcoroner
On the basis of examination and/or investigation. In my opinion, dealh occurred at the time, dale. and place, and due to the cause(s) and manner as stated .........0
33d. Date Signed (Month. day, year)
'3, (( rlDG
strws s~nal\:~~~:er~Q-t.N
l~ I \ 1c9-.1 \ 10 I
34 Name and Address ot Person Who Compleled Cause of Death (lIem 27) TypelPrinl
'J]::'-fl'Lf I G, t;' ..Iv dt~ . (I
~~~ s ~\'1t _~ (a...-I,".sI,4"JlL1 (,UI3
(See instructions and examples on reverse)
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LAST WILL AND TEST AMENT
OF
BENNY E. T A YS
I, BENNY E. T A YES, of Borough of Carlisle, Cumberland County, Pennsylvania, being of
sound and disposing mind, memory and understanding, do hereby make, publish and declare this as
and for my Last Will and Testament, hereby revoking all other wills and codicils heretofore made by
me.
FIRST: I direct that all Illy just debis and funeral expenses, including my grave
marker, shall be paid from the assets of my estate as soon as practicable after my decease.
SECOND: I give and bequeath any vehicle which I may own at the time of my
death to my friend, EDWARD EGE.
THIRD: I give, devise and bequeath the residue of my estate, of every nature
and wherever situate, to my Brother, HERBERT E. T A YS, JR., provided that should he predecease
me his shall be distributed to his children equally living at the time of my death.
FOURTH: I direct that all taxes that may be assessed in consequence of my death,
of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a
part of the expense of the administration of my estate.
FIFTH: I nominate, constitute and appoint, EDWARD EGE, Executor of this
my Last Will and Testament. Should EDW ARD EGE~ fail to q1.!alify Qr cease to act as Executor, I
appoint DEBORAH EGE, Executrix of this my Last Will and Testament.
SIXTH: I direct my Executor and his successors shall not be required to give
bond for the faithful performance of their duties in this or any other jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and
Testament, consisting of one (1) typewritten pages, each identified by my signature, this 16TH day of
July 2004.
, B.A- 4lA'l1
Benny E. Tays
t--(J
(SEAL)
Signed, sealed, published and declared by the above-named Testator, BENNY E. T A YS, as
and for his Last Will and Testament, in the presence of us, who, at his request, in his sight and
presence, and in the sight and presence of each other, have scrio our ames as
witnes
COMMONWEALTH OF PENNSYLVANIA )
: SS.
COUNTY OF CUMBERLAND )
I, BENNY E. T A YS, Testator, whose name is signed to the attached or foregoing instrument,
having been duly qualified according to law, do hereby acknowledge that I signed and executed the
instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free
and volunt~y act for the purposes therein expressed.
Sworn or affirmed to and acknowledged before me by Benny E. Tays, the Testator, this 16th
day of July 2004.
NOTARIAL SEAL
SHELLY SEXTON. Notary Publk:
Carlisle Bore, Cumberland County
My Commission Expires April 26, 2007
(SEAL)
AFFIDA VIT
COMMONWEALTH OF PENNSYLVANIA )
: SSe
COUNTY OF CUMBERLAND )
We, RONALD E. JOHNSON and TAYLOR P. ANDREWS, the witnesses whose names are
signed to the attached or foregoing instrument, being duly qualified according to law, do depose and
say that we were present and saw Testator sign and execute the instrument as his Last Will and
Testament; that Benny E. Tays, signed willingly and that he executed it as his free and voluntary act
for the purpose therein expressed; that each of us in the hearing and sight of the Testator signed the
Will as witnesses; and that to the best of our knowledge the Testator was at that time 18 or more
years of age, of sound mind and under no constraint or undue influence.
Sworn or affirmed to and subscribed to before me by RONALD E. JOHNSON and T AYLOR
P. ANDREWS, witnesses, this 16th day of July 2004.
NOTARIAL SEAL
SHELLY SEXTON, Notary Public
Carlisle Boro, Cumberland County
My Commission Expires April 26, 2007